In the emergency department, pain has to be assessed quickly, in order to choose the appropriate analgesic. A simple behavioural scale was needed for young children under 6 years. Elaboration EVENDOL was elaborated by paediatric pain specialists and emergency staff members. The scale includes five items: complaint, grimace, movements, postures, interaction with surroundings, each scored from 0 to 3. Validation The scale was tested at three times: before any care, during mobilisation, after analgesic. Construct validity and interrater reliability were studied. Children were assessed by the nurse and the searcher, with EVENDOL and with a visual analogue scale (VAS) and with other scales. Anxiety and asthenia levels were assessed. Self-assessment scores were obtained from children above 4 years of age. Results 297 children (1 month to 6 years) were included. Construct Validity Scores before/after nalbuphine varied from 8.14 to 3.62 at rest (p Content Validity Excellent Cronbach coefficient (0.83 to 0.92). Interrater reliability between nurses and researcher: correlations 0.89 to 0.98, weighted kappa 0.7 to 0.9. Conclusion EVENDOL, a new five-item scale to assess young children’s pain in the emergency department is validated. EVENDOL is simple and well accepted by nurses.

Une prise en charge optimale de la douleur aux urgences pédiatriques nécessite d’une « culture douleur » à laquelle doit adhérer toute l’équipe sous l’impulsion des « leaders » locaux. La prise en charge comporte principalement la reconnaissance et l’évaluation de la douleur de chaque enfant en fonction de son niveau de développement et de sa pathologie, l’anticipation et la prévention de la douleur liée aux gestes et l’utilisation des moyens non médicamenteux et médicamenteux pour le traitement de la douleur. Souvent, le plus efficace est d’associer ces 2 types de moyens. La prise en charge de la douleur doit débuter le plus précocement possible. Les moyens non médicamenteux dépendent de l’âge et/ou de la préférence de l’enfant ; les plus utilisés sont les solutions sucrées, la succion non nutritive, l’allaitement maternel et la distraction. Les moyens médicamenteux incluent le paracétamol, les anti-inflammatoires non stéroïdiens, le tramadol, la nalbuphine, la morphine, et les anesthésiques locaux. Dans certaines situations la kétamine est aussi utilisée. Cet article décrit les principales stratégies pour évaluer et traiter la douleur de l’enfant aux urgences pédiatriques. La douleur de l’enfant n’est pas une fatalité et tout doit être mis en œuvre pour la prévenir et la soulager.Optimal pain management in the pediatric emergency department requires a “pain culture” to which the whole team must adhere, spurred on by local “leaders”. Management mainly involves the recognition and assessment of each child's pain according to their stage of development and their pathology, the anticipation and prevention of procedural-induced pain, and the use of nonpharmacological and pharmacological approaches for the treatment of pain. Often, the most effective approach is to combine these two types of treatments. Pain management should start as early as possible. Nonpharmacological approaches depend on the age and/or preference of the child; the most commonly used are oral sugar solutions, non-nutritive sucking, breastfeeding, and distraction. Medications include paracetamol, nonsteroidal anti-inflammatory drugs, tramadol, nalbuphine, morphine, and local anesthetics. In some situations, ketamine is also used. This article describes the main strategies for assessing and treating childhood pain in the pediatric emergency department. Pain in children is not inevitable and everything must be done to prevent and relieve it.